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� <br /> SAN JOAQUIN COUNTY ® <br /> ONVIRONMENTAL HEALTH DEPARTMENT 40 - <br /> 304 East Weber Avenue,3rd Floor;Stockton;CA 95202-2708 Id 4f 1 2006 <br /> Telephone:(209)468-3420 Fax (209)468-3433 Web:www.sjgov. R/ehd <br /> UNDERGROUND STORAGE TANK ST PROGRAM INSPEC Y ALTh <br /> Facility name:. Designated Operator: . Inspection Date: <br /> Facility address: UST# >" <br /> Product / <br /> Facility Contact: Titles Phone: <br /> OtL <br /> 't .. <br /> �.,. �- � 17 <br /> T <br /> Monitorin Panel: 1 'P` ing system: 0 Bill prevention: <br /> Pressurized 11Suction ❑'Gravi LI Mechanical ❑Audible/visual <br /> InI ection type, Violations: <br /> 'L9 Routine /Monitoring Certification ❑Installation ❑Other: ❑MI-RDetect ❑M2-RPrev ❑M-3 Both <br /> VIOLATION(S)HSC=Califomia Health&. afety Code;CCR=Califomia Code of Regulations V R <br /> # Code Section � V <br /> V=Violation; V=Re at Violation <br /> 1 HSC 25284 Permit too erate <br /> CCR 263771 1711 .1 <br /> onclary containtnent test perfotxned <br /> 3 CCR 2711 b & c Current Unified Program Consolidated Forms on.file with EHDgacility and tank form) <br /> 4i 2$ 92.2 P00040fi of financial re ` ondbil attd C1a 4'letket <br /> 5 CCR 2632 c 2 D Monitoring&res onse plan is current and filed with the local agency <br /> "8i monse planisonsite <br /> 7 CCR 2712 Maintenance&monitoring records (M 1) <br /> 8 Gid 26 3, . W i0on toring of suction pipingJaft 1,1984 <br /> 9 HSC 25292.1 UST s em isoperated to prevent unauthorized release <br /> tem is present <br /> 11 I CCR 2630 d UST system monitoring equipment is properly located to detect a leak MI <br /> 12 HSC 2 'ag equipment is operational <br /> 13 CCR 2636 f)(1) Continuous monitoring s tem for under round 2iping&UDC is present Ml <br /> 14 C a) i6ntainment is uct t" t <br /> 15 ,HSC 25291 (a)(2) Secondary containment for UST is ti ht <br /> 16 -' . . (c)(1) Alh ,*s 'Piping flowAA-Acollecttun <br /> 17 HSC 25 "Lin 1eW-det­e&6rk§j are installed - MI <br /> 19 CCR 2635 U21 Overfill prevention s stem M2 <br /> 0 CM at:,suctaan ' in atall havecntitntotts nen 2°contai#uttent;" <br /> 21 HSC 25291 e) Water in 2°containment analyzed& ro 1 'dis osed of <br /> . . -." ©rdtn 'r•'" 'rtin `taf iittat? `:' + s <br /> 23 CCR 2715 Desieat ed O erator: a Statement from UST owner; (c-e)Monthly inspection;(0 Employee training <br /> 25 CCR 2638(a) Annual line leak detector test MI <br /> a: <br /> 27 CCR 2636 4 Annual Iine tightness test 1 <br /> 29 CCR 2643 jeBiennial tightness test of gravity piRingre-Janu 1 1984 <br /> "..a test for conv�al sue ti <br /> 31 HSC 25292.5 Double wall s stem located within 1000'of public,well-ELD w <br /> C lU5T system <br /> 33 HSC 25286 a Permit to alter monitoring system <br /> Pmt close UST em <br /> 35 HSC 25298 c ste <br /> Permit to close UST s m <br /> ithk detection devices <br /> 37 HSC 25298 a Ille al abandonment of UST system <br /> _'EHD INSPECTOR:: PHOP1 UIC <br /> i�,�-i � � Septic system: <br /> ❑Serves>20 people/day <br /> RECEIVED Rii` - TITLE: ❑Receives,other than sanitary waste <br /> T Other di=sal methods: <br /> f,A _ i (� ❑Dry wells/French Drains <br /> F,HD 23-02-002 <br />